Provider Demographics
NPI:1417566670
Name:WORKENEHE, ALEFE WUBGIZIE
Entity Type:Individual
Prefix:
First Name:ALEFE
Middle Name:WUBGIZIE
Last Name:WORKENEHE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1633 E WOODMEN RD APT 20
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80920-3301
Mailing Address - Country:US
Mailing Address - Phone:857-261-0408
Mailing Address - Fax:
Practice Address - Street 1:1633 E WOODMEN RD APT 20
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80920-3301
Practice Address - Country:US
Practice Address - Phone:857-261-0408
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-23
Last Update Date:2020-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1417566670172A00000X
343900000X, 172A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No172A00000XOther Service ProvidersDriver